Environmental and demographic determinants of dengue incidence in Brazil
Determinantes ambientales y demográficos asociados con la incidencia del dengue en Brasil
DOI:
https://doi.org/10.15446/rsap.v20n3.54315Keywords:
Dengue, environmental health, population dynamics, regression analysis, Brazil (en)Dengue, salud ambiental, dinámica poblacional, análisis de regresión, Brasil (es)
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Objective To analyze the spatial distribution of dengue fever cases within an urban area of the São Paulo State, southeast Brazil.
Methods Based on a methodology created by the authors, it was possible to organize the Brazilian Census data of 2010 into a regular grid of 250x250 meters each cell. This cell was the unit of analysis. Then, the 1 688 residential addresses of autochthonous dengue cases reported in 2013 in Caraguatatuba city were geocoded to calculate the incidence rate by cell. The dependent variable was the dengue incidence rate and the independent variables were classified into two types: environmental and sociodemographic. Finally, a Zero-Inflated Negative Binomial Regression was performed using the software R.
Results The statistical analysis showed an association between dengue incidence rate and the environmental variable “proximity to strategic points (junk yards, tire repair shops and deposits of recyclable materials).” Dengue was also associated to the sociodemographic variables “proportion of households with per capita income up to 3 minimum wages”, “proportion of nonwhite people” and “proportion of not owned households”.
Conclusion Dengue is associated to several factors related to its epidemic outbreak. In this complex context, results suggest that this infectious disease is socially conditioned, since it is more likely to reach population groups with specific characteristics, notably those with low socioeconomic status.
Objetivo Analizar la distribución espacial de los casos de dengue dentro de un área urbana en el estado de Sao Paulo, sudeste de Brasil.
Métodos Basados en una metodología creada por los autores, se organizaron los datos del censo brasileño de 2010 en una malla regular de 250x250 metros cada célula. Esta célula fue la unidad de análisis. En seguida, fueran gecodificadas todas las 1 688 residencias de los casos de dengue registrados en 2013 en la ciudad de Caraguatatuba para calcular la tasa de incidencia por célula. La variable dependiente fue la tasa de incidencia del dengue y las variables independientes fueron clasificadas en dos tipos: ambientales y sociodemográficas. Finalmente se realizó una Regresión Binomial Negativa Inflada con Ceros utilizando el software R.
Resultados El análisis estadístico mostró una asociación entre la tasa de incidencia del dengue y la variable ambiental proximidad de puntos estratégicos (depósitos de chatarra, talleres de reparación de neumáticos y depósitos de materiales reciclables). El dengue también se asoció a las variables sociodemográficas proporción de hogares con ingreso per cápita de hasta 3 salarios mínimos, proporción de personas no blancas y de hogares que no sean propiedad.
Conclusión Se concluyó que el dengue tiene un conjunto múltiple de factores relacionados con la aparición de sus epidemias. En el contexto de esta complejidad, los resultados sugieren que esta enfermedad infecciosa está condicionada socialmente, ya que es más probable que llegue a grupos de población con características específicas, especialmente aquellos con un nivel socioeconómico bajo.
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